The metallic materials used today for surgical implants are:                stainless steel in accordance with international standard ISO-Norm 5832-1;        cobalt-chromium-molybdenum alloys in accordance with ISO 58324, 5832-5 and 5832-6;        unalloyed titanium in accordance with ISO 5832-2;        alloys: titanium-aluminum-vanadium (Ti6Al4V) in accordance with ISO 5832-3; titanium-aluminum-iron (Ti5Al2, 5Fe) in accordance with ISO 832-10; titanium-aluminum-niobium (Ti6Al7Nb) in accordance with ISO 5832-11.        
“The ability of a material to perform with appropriate host response in a specific situation” (cf. D. F. Williams: in Biomaterials: Proceedings of a Consensus Conference of the European Society for Biomaterials. Elsevier Science Publ. Amsterdam, 1989). The foreign body produces only a minimal reaction in the living tissue. In the tissue in contact with the metal, sequestration in the form of encapsulation without pathological cell forms, or inertia, detectable as loose connective tissue, is observed (cf. S. G. Steinemann: Corrosion of Titanium and Titanium Alloys for Surgical Implants. Titanium, Science and Technology, Proc. 5th Int. Conf. Titanium. [G. Lütjering, U. Zwicker, W. Bunk, eds.], Deutsche Ges. Metallk. Oberursel, 1985, 1373).
For dental implants that are anchored in the bone, a higher form of tissue compatibility, namely osseointegration, is effective. In P.-I. Branemark, G. A. Zarb. T. Albrektsson [editors]: Tissue-Integrated Prostheses, Quintessenz Publ. Chicago, 1985, p. 11, we read: “Osseointegration is defined as a direct structural and functional connection between ordered, living bone and the surface of a load-carrying implant.” This reaction implies an interaction between the foreign body and the living tissue, that is, more than just inert behavior of the metal. Dental implants are produced from titanium. For this metal, animal tests have shown complete anchoring, namely a rigid connection against the effects of pressure, shear and tension (cf. S. G. Steinemann, F. Straumann: [Ankylotische Verankerung von Implantaten] Ankylotic Anchoring of Implants. Schweiz. Mschr. Zahnmed. 94, 1984, 682). Complete anchoring also means adhesion, which is attributed to chemisorption (cf. S. G. Steinemann, J. Eulenberger, P.-A. Mäusli, A. Schroeder: Adhesion of Bone to Titanium. Biological and Biomechanical Performance of Biomaterials [P. Christel, A. Meunier, A J. C. Lee, eds.], Elsevier Sci. Publ. Amsterdam, 1986, 409).
Implants of bone and dental surgery are subject to high stresses and must be mechanically strong. Important parameters are yield point, elongation at break and modulus of elasticity. Stainless steel and unalloyed titanium have low strength and are therefore cold worked. For titanium, this increases the tensile strength from approximately 500 MPa to approximately 700 MPa. However, the strength of the two standard titanium alloys, which ranges from 900-1000 MPa, is not reached.
One experiment for measuring osseointegration is the implant expulsion test. For this purpose, a cylindrical implant is inserted into the bone in animal tests and the expulsion force is determined as a function of the rest period, typically 12 weeks. Such experiments have shown that the anchoring of mechanically roughened unalloyed titanium, Ti6Al4V and Ti6Al7Nb, is equal in strength but that a mechanically roughened and chemically etched surface for pure titanium implants results in much higher expulsion forces than an identical surface treatment for alloy implants (cf. M. Wong, J. Eulenberger, R. Schenk, E. Hunziker: Effect of surface topology on the osseointegration of implant materials in trabecular bone. J. Biomed. Mater. Res. 29, 1995, 1569). One or all of the three alloyed elements Al, V, Nb obviously inhibits integration in the bone.
Pure titanium and titanium alloys may exhibit local corrosion in narrow crevices if exposed to hot chloride-containing electrolytes. Manuals specify temperatures above 70° C. (cf. B. Craig: Technical Note Corrosion. in Material Properties Handbook: Titanium Alloys [R. Boyer, G. Welsch, E. W. Collings, eds.], ASM Int., Metals Park Ohio, 1994, 1065). However, there is clinical literature reporting corrosion in the crevice of cone connections of artificial hip joints and on the shaft of such prostheses in the cement bed. The known titanium materials for implants are obviously not resistant to crevice corrosion.
[Swiss Patent Application] CH-A-544 154 discloses a binary titanium-zirconium alloy with 25-75% by weight Zr for implants. The composition range corresponds to high mechanical strengths. These metals are reactive, exhibit exothermal oxidation and are therefore not easy to process. On the other hand, the alloy formula corresponds to an atom concentration of 15-61% Zr, i.e., the added element strongly influences electrochemical and biological reactions. This is not desirable and the reactions specific to titanium in the living tissue should not be lost.